Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit  neurosurgery.tv

Functional Neurosurgery
functionalneuro.surgery
Functionalneurosurgery.net

IOM Sites
iomonitoring.org
operativemonitoring.com

Neurosurgical Sites
neurosurgery.art
neurosurgery.me
neurosurgery.mx
skullbase.surgery

Neurosurgical Encyclopedia
neurosurgicalencyclopedia.org

Neurooncological Sites
acousticschwannoma.com
craniopharyngiomas.com
ependymomas.com
gliomas.info
meningiomas.org
neurooncology.me
pinealomas.com
pituitaryadenomas.com 

Neuroanatomical Sites
humanneuroanatomy.com 
microneuroanatomy.com

Neuroanesthesia Sites
neuro-anesthessia.org

Neurobiological Sites
humanneurobiology.com

Neurohistopathological
neurorhistopathology.com

Neuro ICU Site
neuroicu.info

Neuroophthalmological
neuroophthalmology.org

Neurophysiological Sites
humanneurophysiology.com

Neuroradiological Sites
neuroradiology.today

NeuroSience Sites
neuro.science

Neurovascular Sites
vascularneurosurgery.com

Personal Sites
cns.clinic

Spine Surgery Sites
spine.surgery
spondylolisthesis.info
paraplegia.today

Stem Cell Therapy Site
neurostemcell.com


Inomed Stockert Neuro N50. A versatile
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Multigen RF lesion generator .

29-AUGUST-2015 HALIMEH ABDEL-HAFEZ ABU-ALGHANAM  74 YEARS CERVICAL CANAL STENOSIS C3-4 AND C5-6 WITH MALACIA OF THE SPINAL CORD AT C3-4.

 

Anamnesis

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The patient came to the clinic 28-July-2015 complaining of neck pain with both shoulder pain for 3 months with gradual onset associated with feeling of four limbs weakness with inability to stand and walk independently with tendency to fall down. She is in wheelchair for 2 months. The patient is a known diabetic and hypertensive for 15 years in treatment.

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On examination: the patient is in wheelchair. He profound weak both hands 3/5 extension and flexion both hands with weak deltoids, triceps and biceps both upper limbs 3-4/5, more weak in the left. There is Hoffmann both sides with exaggerated deep reflexes with no sensory apparent disturbances. Both lower limbs muscles proximal and distal are weak 3-4/5, more weal the distal muscles with Babinski positive both side with persistent clonus and SLRS 40 due to weakness. The micturition and sphecteric functions are normal.

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The patient was sent for investigations. MRI of the brain performed 09-August-2015 showed periventricular changes compatible with age. There are no major problems in the brainstem to explain her condition. MRI cervical performed 15-Auagust-2015 showed severe cervical stenosis of C3-4 and C5-6 with malacia of the spinal cord more behind C3-4. Cardiac consultation performed and anticoagulation stopped.

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Decompressive laminectomy C3-4-5 and C6 was performed. The ligamentum flavum was severely constricting the spinal cord at C3-4 level and was adherent to the dura. Sharp dissection of the dura to remove the constricting bands. The dura was relatively thick at this area with fibrotic tissues holding the suspicion of previous trauma. Strict hemostasis and routine closure.

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Smooth postoperative recovery. The power of the four limbs improved slightly after surgery. The patient was sent to the ward.

 

Comments  

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The patient has severe stenosis with malacia of the spinal cord. The course is progressive and the sooner the decompression, the better the outcome.

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Consider if the patient having other pathologies such as ALS. First MRI of the brain did not show the signs of this or other pathologies and nor the clinical examination. Even if there is coincidental pathologies, decompression is a must.

Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.


Inomed Riechert-Mundinger System, with three point fixation is the most accurate system in the market. The microdrive and its sensor gives feed back about the localization.


Inomed MER system

Leica HM500

Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and documentation.

TRUMPF TruSystem 7500

After long years TRUMPF TruSystem 7500 is running with in the neurosuite at Shmaisani hospital starting from 23-March-2014

 


Back Up!

Notice: Not all operative activities can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also escaped from the plan .

WELCOME TO AL-SHMAISANI HOSPITAL

 


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